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Laser Cataract Surgery FAQ

Q: When should a patient consider having cataract surgery?

Stephen Slade MD: You know, with cataract surgery it's a little different from having Lasik or having PRK. With Lasik and PRK, if I decide I wanna wait, then, I can wear glasses and contacts and likely still see 20/20. With a cataract, by definition, something's clouding my vision that glasses won't fix. So how long do you want to wait? Now, even so, cataract surgery is elective surgery. We always tell patients it's nothing to be apprehensive about, because it is such good surgery. And the safety record is so good. The risks are there, and real, but low. And with laser cataract surgery, it's even better. So it's nothing to be apprehensive about. Luckily it's also something you don't have to rush into. You just won't see as well as you could, with anything until you have the cataract fixed. The cataract won't damage your eye by being in there. It's not going to, you know, damage structures. And, you know, you can, you know, take your time. Typically you could have it done next week, next month or even next year. But the vision will get worse, typically, as time goes on. And it won't get better. So when you get to the point where you can't do the things you want to do, whether it's drive at night, read, see the golf ball at a zillion yards, or whatever you were used to doing and you can't do now. Then that's the time to start thinking about having cataract surgery. To be evaluated, see what your options are and then make up your decision. It's elective surgery. The decision is yours. We can provide the information, there's no rush. You just won't see well, typically, until you have it fixed.

Q: What is the difference between standard cataract surgery and the laser cataract surgery that you do?

Stephen Slade MD: Standard cataract surgery is what we've done for years and years. It's taking the cataract out, and it's a wonderful technique. It's taking the cataract out through a tiny incision, with an ultrasonic needle. That being said, the amazing advance that we've been doing for years, since February of 2010, in Houston, is laser cataract surgery. No matter what we say, people, a lot of people have always thought that we do cataract surgery with a laser. We haven't been. I mean, I have to tell people that every day,"No, it's not done with a laser." We do use this little ultrasonic needle. But that's been going on for about 25 years. Laser cataract surgery is actually using a laser, where there is no cutting on the eye, with metal blades. It's using the laser to do about two and a half, uhm.. of the five steps of cataract surgery. About half of the procedure, the laser now does. It's a far more precise way to make the incisions into the eye, for example, and you don't use a blade. It's a far more precise way to make the opening into the lens, without having to use a manual technique to make that opening. It's a no-touch technique to actually break apart and soften the lens, so that it can be removed more easily. It shortens the time that we spend inside the eye, and it gives us a more precise way of doing all of these different things to the eye. So, in our experience with it, it adds safety. A lot of different safety factors, and it adds precision.

Q: Will standard (ultrasonic) cataract surgery become obsolete in the near future?

Stephen Slade MD: The laser can't directly remove things from the eye. What it can do is make all the incisions, make all the-- into the eye. Make all of the openings into the lens, it can break up the lens. It can get it softened. It can get it ready to be taken out, but in most people we'll use the ultrasound to remove that. So I don't think it's going to make ultrasound go. In fact, I think the real clever physicians will be the ones that best blend the laser cataract surgery with the techniques of ultrasound so that we use, again, the laser sort of to do the first half of the surgery. And then the ultrasound, optimized to the laser, to do the second half of the surgery in a quicker, faster way. For example, we have found with the laser, we're able to use less ultrasound. We have found with the laser first, that we do less manipulation of the eye. We spend less time in the eye. We use less ultrasound. And the eye actually winds up in a healthier state. Because the less we do, typically with eyes, the better. So they actually work beautifully together. The laser does the first half. We use the ultrasound and the surgeon to do the second half. And we're- we're winding up with a faster, more precise, more predictable, safer surgery that leaves the eye more intact. It leaves the eye alone more and is gentler. A kinder, gentler approach to the eye surgery which will translate out to better results. We're seeing people that have a more precise result. A more accurate result and a quicker result. They're seeing better, faster, quicker, more accurately. We're pretty excited about it.

We're really pleased with our results right now. We're finding that we use less ultrasonic energy in the eye. We put less energy in the eye. The surgery times are quicker so there's less manipulation of the eye. The eyes look better the next day. Patients are seeing extremely well. We find that the eyes are less disturbed. Uh.. cell counts are higher. Just all these different metrics. We also, because we're making such a precise place to put the lens with the laser, we find that the accuracy of our lenses is better... significantly. We're very excited about that. And that's so important with the advanced IOLs. Since we're using the laser to correct astigmatism, we're finding our visions are better with our patients with no glasses at all. So, we're very happy about that. Results have been already significantly above what we had before, which were pretty good, we thought.

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